In 36 states, calling for help for a heroin overdose can put users behind bars.Darrin Klimek/Thinkstock
As Philip Seymour Hoffman’s friends, family and admirers come to terms with his tragic and untimely death and fentanyl-laced heroin kills addicts across the Northeast, the media have responded to the news in the best way it knows how: with a seemingly endless stream of programming on the dangers of heroin and the tenuous lives of those who use it. Unfortunately, even when they get it right, there are often crucial factors missing from the discussion.
For example, on CNN’s “Anderson Cooper 360” on Tuesday night, guest Ric Curtis of the John Jay College of Criminal Justice, recommended that one way to mitigate the risk of overdose is for users to partner up, allowing them to keep an eye on each other and call 911 in case one of them runs into trouble.
Curtis is right, of course. That’s a great strategy. Unfortunately, even though studies show that most overdoses occur in front of witnesses, thousands still die each year in the company of others because they or the people they are using with are too afraid of police harassment or arrest to call for help. They have good reason to be. In 36 states, calling 911 can land a person in jail.
According to the Drug Policy Alliance, only 14 states and the District of Columbia have passed so-called 911 good Samaritan laws that absolve callers of minor wrongdoing — including drug possession — if they notify police or rescue services of an overdose in progress. Propelled by a spike in overdose deaths, New Mexico broke ground with the nation’s first good Samaritan law for drug users in 2007, and Washington adopted similar legislation in 2010. Over the past three years, a dozen states have followed suit, but the laws remain controversial, and in many cases, implementation has been slow and inconsistent.
Supporters of 911 good Samaritan laws — including the U.S. Conference of Mayors and the National Conference of State Legislatures — claim, rightfully, that they represent a common-sense approach to a serious public-health issue. But not everyone is convinced. In 2010, after California’s legislature passed a bill that would have granted immunity for three minor crimes to drug users who report overdoses, then-Gov. Arnold Schwarzenegger vetoed the measure on the grounds that it “fails to address problematic, high-risk drug use and behavior.”
California finally enacted a good Samaritan law in 2012, after Schwarzenegger left office. In other states — including Pennsylvania, where dozens of users have died over the past month from heroin cut with fentanyl, a powerful narcotic — legislatures have let similar bills languish in committee.
If Philip Seymour Hoffman’s death taught us anything, it’s that addiction is often a silent disease hiding in plain sight.
It’s not hard to guess why. Drug addicts — and heroin users in particular — are a population that most people give little thought to until someone in their family hits bottom or a celebrity they admire dies unexpectedly. Addicts don’t have their own lobbyists, and they don’t typically write big checks to political campaigns. Unless addiction has touched you or your family personally, it’s easy to ignore the benefits of what some critics see as a get-out-of-jail-free card for irresponsible behavior.
If Hoffman’s death taught us anything, it’s that addiction is often a silent disease hiding in plain sight. At any given time, the person on the other end of that 911 call could be trying to save the life of someone you know or care about. When and if that ever happens, the last thing you’ll be thinking about is whether they’ll face charges after they hang up.
Good Samaritan laws may not reduce drug use, but they do appear to be reducing drug-related deaths. In states that have such laws on the books, research has found that addicts are now less likely to avoid calling 911 or rely on half measures like a cold shower when one of their friends falls out. A 2011 study by the University of Washington found that 88 percent of opiate users polled by outreach workers said they would be more likely to call for assistance during future overdoses in light of that state’s good Samaritan law. And police said they would be less likely to make arrests.
Unfortunately, not all good Samaritan laws are created equal. Some, such as Delaware’s recently enacted overdose-prevention law, are broad and cover all nonfelony drug-related offenses. Yet others include unreasonable restrictions such as basing eligibility for immunity on a caller’s criminal history and covering only possession-related offenses — meaning that if you’re the one who supplied your friend the drugs, your immunity goes out the window.
Others still practically require legal aid for the average user to understand. In New York, for instance, a person who calls 911 may be immune from charge and prosecution for possession of up to 8 ounces of a controlled substance but is still subject to arrest for anything over 3.5 grams. Besides the fact that heroin isn’t typically sold at street level in grams — making it hard to know exactly how much you have — for an opioid-dependent person hours from the onset of withdrawal, there’s little comfort in knowing you’ll be released without charge after spending two or three days going cold turkey in a jail cell.
No silver bullet
This lack of uniformity among state laws is aggravated by the fact that even when such laws are passed, there is often no directive or funding for community outreach, so many addicts are unaware they even exist. And to make matters worse, overdose prevention at the federal level has been practically nonexistent.
One place Barack Obama’s administration could start would be making it easier for harm-reduction programs to get their hands on naloxone, an opioid antagonist with the power to reverse a full-blown overdose. Most but not all good Samaritan states include a provision for getting naloxone into the hands of drug users, but the American Medical Association has identified a number of barriers to adequate distribution. These include chronic drug shortages and restrictive Food and Drug Administration policies, like requiring a prescription to acquire the drug. Among other things, health officials have urged the FDA to make naloxone an over-the-counter-plus medication, which would give pharmacists more discretion over dispensing.
Good Samaritan laws aren’t a silver bullet. Given that Hoffman died alone, none of these measures could have saved him once he put the needle in his arm. But his death has sparked an important discussion that could save thousands of other lives if we’re willing to ask the right questions.